Common Errors We See in Pharmacy Inspections and How to Avoid Them
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm Pharmacies and pharmacists are subject to many types of inspections. These inspections are necessary to determine whether the business and its employees are complying with state and federal […]
OIG Exclusion: Do You Know if You’re on the List?
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health La Have you ever faced a disciplinary action against your professional license? Have you ever been arrested or convicted of a criminal offense? If yes, then you may have also been terminated from the federal Medicare Program or your […]
OIG Exclusion: What You Need to Know if You’re on the List
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Have you ever had disciplinary action against your license as a health care professional? Have you ever been arrested or convicted of a criminal offense? Have you ever been convicted of fraud or patient neglect? If so, then […]
Health Care Professionals Need to be Compliant with Anti-Fraud Laws
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The federal government has several tools available to help combat Medicare fraud. Among those are the Stark Act, Anti-Kickback laws and Civil Monetary Penalty Laws. Each of these typically focuses on a particular type of behavior that is […]
Speech Therapist Arrested for Billing Medicaid $500,000 for Work at Florida Day Care Centers While Living in Illinois
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A speech therapist was arrested on March 29, 2013, for allegedly billing Medicaid more than $500,000 for services that she did not provide, according to the Florida Office of the Attorney General (AG). The speech therapist now faces […]
Appeals Court Upholds Medical Malpractice Law Changes
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On July 21, a state appeals court in Tallahassee upheld the constitutionality of a controversial change in Florida’s medical malpractice law. It ruled that some privacy rights are waived when patients pursue medical malpractice lawsuits. A federal appeals […]
Tuomey Healthcare System Ordered to Pay a Reduced $238 Million in Damages for Allegedly Violating Stark Law and False Claims Act
Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On September 30, 2013, a federal judge ordered Tuomey Healthcare System in Sumter, South Carolina, to pay $238 million in penalties and fines. The hospital system is accused of paying […]
Florida Woman Arrested for $400,000 Medicaid Fraud Scheme
By Lance O. Leider, J.D., The Health Law Firm The owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has allegedly been arrested for defrauding Medicaid out of more than $400,000, according to the Florida Office of the Attorney General (AG). The owner is charged with billing Florida’s Aged and Disabled Adult Waiver Program for services […]
New Professional Liability Insurance Benefits for Health Professionals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law I have been pleasantly surprised recently to discover that several professional liability insurance companies have raised their coverage amounts and added coverage in areas sorely needed by health professionals. I’m referring to coverage for incidents not necessarily related […]
Drug Enforcement Administration Releases Details of Investigation into Two CVS Stores in Sanford, Florida
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2012, the Drug Enforcement Administration (DEA) revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. Details into the investigation were made public on October 12, 2012, in a final order released by the […]
CVS Possibly Under Investigation for Medicare Fraud
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) has reportedly launched an investigation into CVS’ practice for refilling prescriptions. According to an article in the Los Angeles Times, authorities are […]
The Importance of Complying with the Stark Law and Other Anti-Fraud Laws
By Lance O. Leider, J.D. The federal government has several tools in its toolbox to combat Medicare fraud. Among those are the Stark Act, Anti-Kickback laws, and Civil Monetary Penalty Laws. Each of these typically focuses on a particular type of behavior that is prone to abuse by healthcare providers. The following focuses on the […]
CVS Has Allegedly Been Refilling Prescriptions and Submitting Insurance Claims Without Patients’ Permission
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) has reportedly launched an investigation into CVS’ practice for refilling prescriptions. According to an article in the Los Angeles Times, authorities are […]
Locating a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]
Walgreens Files a Petition to Lift the Immediate Suspension Order
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a firefight brewing between Walgreens and the Drug Enforcement Administration (DEA). On October 10, 2012, Walgreens filed a petition asking a federal judge to lift the Immediate Suspension Order (ISO) that bans its distribution center in Jupiter, […]
Sanford CVS Pharmacies in Hot Water for Ignoring Red Flags
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In September 2012, the Drug Enforcement Administration (DEA) revoked the controlled substance licenses from two CVS pharmacies in Sanford, Florida. Details into the investigation were made public on October 12, 2012, in a final order released by the […]
Nurses: Locate a Healthcare Providers Service Organization (HPSO) Insurance Defense Attorney in Florida Company Cases
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]
Central Florida Mental Health Counselor Accused of Heading Up $3 Million Medicaid Fraud Scheme
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law A registered mental-health counselor is accused of running a $3 million Medicaid scheme through the mental health facility she owned, according to the […]
Woman Admits to Defrauding Medicaid For Fake Mental and Behavior Health Services
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A North Carolina woman pleaded guilty on September 14, 2012, for her involvement in a health care scheme that allegedly defrauded Medicaid from 2008 to 2011 for fake mental and behavior health services. Through this scheme, she allegedly […]
The Lone Star State’s New Task Force to Take a Bite Out of Medicaid Dental Fraud
George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law There’s a new task force riding into Texas. According to The Texas Tribune, the Texas Attorney General’s (AG) Office and the Office of Inspector General (OIG) at the Health and Human Services Commission (HHSC) have teamed up to increase […]
United Parcel Service (UPS) Agrees to Pay Settlement for Online Pharmacy Shipping
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law United Parcel Service, Inc. (UPS) will pay $40 million to the Department of Justice (DOJ) to settle a probe related to its shipments on behalf of illicit online pharmacies. This announcement came on March 29, 2013. Click here […]
Florida’s Medicaid Program Receives Settlement Payment from Pharmaceutical Company
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU), 46 other states and the federal government reached a $48 million agreement with pharmaceutical company Healthpoint Ltd., on February 25, 2013. According to the Florida AG, the settlement […]
Finding a Healthcare Providers Service Organization (HPSO) Insurance Defense Lawyer
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law We are sometimes told by the health professionals we represent especially pharmacists, licensed mental health counselors (LMHCs), advanced registered nurse practitioners (ARNPs), massage therapists and physical therapists that after they received a complaint regarding their license from the […]
Drug Enforcement Administration (DEA) Investigates Six Walgreens Pharmacies in Florida
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Drug Enforcement Administration (DEA) served an Order to Show Cause (OSC) on a Fort Myers Walgreens pharmacy on February 21, 2013. According to the DEA, the OSC was served as a notice to provide Walgreens with an […]
New OIG Guidance Publishes on Permissive Exclusions from Federal Health Care Program Participation May Interest Mental Health Care Professionals
By Miles Indest, J.D./M.B.A candidate at Tulane University: Law Clerk, The Health Law Firm On April 20, 2016, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released updated non-binding criteria that disclosed when a company or individual can be barred from participating in Medicare, Medicaid, and other federal health care […]
Key West Pharmacy Blows Whistle on Medicaid Fraud and Comes Out on Top
By Danielle M. Murray, J.D. On September 27, 2012, Public Citizen, a watchdog group, reported whistleblowers have initiated $6.6 billion in penalties against drug manufacturers in 2012. Most of these penalties are for fraudulently overcharging government programs. The report names a small Key West, Florida, pharmacy as one of the top whistleblowers in the country. […]
Purpose of Florida E-FORCSE Prescription Database Not for Disciplinary or Criminal Prosecution Purposes Against Physicians, Pharmacists or Other Health Professionals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law As you are no doubt aware now, Florida has an active prescription drug monitoring program (PDMP). It is called the “Electronic-Florida Online Reporting of Controlled Substances Evaluation” or “E-FORCSE.” More often it is referred to simply as the […]